Atopic Dermatitis in Adults: Impact on Sexuality

People are insecure. It’s a fact. They worry about lots of things: aging, money, job security, and illness, just to name a few. Add sexuality to that list, especially for people worried about how skin conditions alter appearance.

Being in a healthy romantic relationship is something most people hope for, and intimacy is a part of most partnerships. Sex should be something that brings joy and satisfaction. But for some, particularly those with atopic dermatitis (AD), fear and discomfort interfere. People with skin conditions often feel uncomfortable in public; they get embarrassed and tend to have more
social fears. Many find themselves preferring isolation, avoiding social situations and relationships.

Skin conditions can interfere with sex

There aren’t a lot of studies that have evaluated atopic dermatitis’ impact on sexuality. Results from a recent French study found that over 80% of patients with AD self-reported it had an impact on their sexual behavior.1

12% of the study participants reported genital involvement of their skin condition. The more severe the AD, the greater the reported impact on libido. Patients with atopic dermatitis report more fears of sex. 59% of those with genital involvement said that this was the most distressing part of their condition.1 In the general population of people with atopic dermatitis, intermittent genital involvement was relatively common.

The results from this study echo findings from other research on the impact of skin conditions on perceived sexuality. They suggest that there is more to be learned and addressed in educating and supporting people with chronic skin conditions.

Sexual self-image

Self-esteem and sexual self-image are often concerns for those with AD. The appearance and texture of affected skin can make you feel less appealing, less attractive. The avoidance of intimate situations and sexual well-being can inhibit people from seeking new social opportunities, participating in public gatherings as well as affect long-standing intimate relationships. This can cause distress.

Performance anxiety and self-confidence affect all kinds of people. When you feel unattractive because of a skin condition that won’t go away, it can impact your emotional well-being. Looking for ways to enjoy life and find pleasure can help to support your self-esteem.

Loss of sexual function

Many chronic conditions can have an impact on sexual well-being. Genital lesions can be painful
and interfere with sexual performance. When skin is itchy, raw or sore some may be uncomfortable being touched. This can reduce your interest in or capacity for intimacy. There are other ways to be affectionate and encourage closeness. Communicating with your partner should reinforce your desire to please the partner regardless of AD.

Quality of life

Skin conditions impact quality of life. They are not well understood by the general public. Visible skin areas affected by atopic dermatitis can be unsightly, uncomfortable and itchy. Many feel self-conscious as if everyone is staring at them. This can interfere with work school, social life, and general health.

Everyone wants to feel attractive. With skin conditions, there can be negative effects on self-
perceived sexual attractiveness and self-confidence, sexual functioning and sexual relationships. People want to feel attractive.2 Support services and education can offer people with AD ways to improve quality of life. Techniques can be learned to foster good communication skills and self- confidence when talking with friends and partners about their skin condition.

Solutions

More can be done to educate and support people with atopic dermatitis beyond general skin care. Physicians should treat more than just the skin condition. Increased awareness of the psychological impact of dermatological conditions on the well-being of their patients can improve physician care. Education and counseling should be an integral component of care. Support programs and different kinds of therapy to address these fears and insecurities can improve the lives of people with AD.

It is important to be able to be open to talk about sex and any concerns about intimacy. Many are so concerned with their dysfunction that they forget there are other aspects of relationships and intimacy that are more than sexual intercourse. Other kinds of physical intimacy can provide pleasure and closeness in a satisfying way.

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